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. 2022 Aug 11:13:952865.
doi: 10.3389/fpsyt.2022.952865. eCollection 2022.

Acceptability and satisfaction with emma, a smartphone application dedicated to suicide ecological assessment and prevention

Margot Morgiève  1   2   3   4 , Daniel Yasri  1   2 , Catherine Genty  1   2 , Jonathan Dubois  1   2 , Marion Leboyer  5   6   7 , Guillaume Vaiva  8   9   10 , Sofian Berrouiguet  11 , Jérôme Azé  12 , Philippe Courtet  1   2   5
Affiliations

Acceptability and satisfaction with emma, a smartphone application dedicated to suicide ecological assessment and prevention

Margot Morgiève et al. Front Psychiatry. .

Abstract

Background: As mHealth may contribute to suicide prevention, we developed emma, an application using Ecological Momentary Assessment and Intervention (EMA/EMI).

Objective: This study evaluated emma usage rate and acceptability during the first month and satisfaction after 1 and 6 months of use.

Methods: Ninety-nine patients at high risk of suicide used emma for 6 months. The acceptability and usage rate of the EMA and EMI modules were monitored during the first month. Satisfaction was assessed by questions in the monthly EMA (Likert scale from 0 to 10) and the Mobile App Rating Scale (MARS; score: 0-5) completed at month 6. After inclusion, three follow-up visits (months 1, 3, and 6) took place.

Results: Seventy-five patients completed at least one of the proposed EMAs. Completion rates were lower for the daily than weekly EMAs (60 and 82%, respectively). The daily completion rates varied according to the question position in the questionnaire (lower for the last questions, LRT = 604.26, df = 1, p-value < 0.0001). Completion rates for the daily EMA were higher in patients with suicidal ideation and/or depression than in those without. The most used EMI was the emergency call module (n = 12). Many users said that they would recommend this application (mean satisfaction score of 6.92 ± 2.78) and the MARS score at month 6 was relatively high (overall rating: 3.3 ± 0.87).

Conclusion: Emma can target and involve patients at high risk of suicide. Given the promising users' satisfaction level, emma could rapidly evolve into a complementary tool for suicide prevention.

Keywords: acceptability; ecological momentary assessment (EMA); ecological momentary intervention (EMI); mHealth; prevention; satisfaction; smartphone application; suicide.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Emma’s assessments.
FIGURE 2
FIGURE 2
Algorithm for automatic ecological momentary intervention (EMI) triggering according to the ecological momentary assessment (EMA) answer thresholds.
FIGURE 3
FIGURE 3
Flowchart of patients’ inclusion.
FIGURE 4
FIGURE 4
Completion rate according to the question position in the daily EMA. Relationship between the question ranking in the daily EMAs and the completion rate. The predicted probability (blue curve) from the logistic mixed model and its 95% CI (shaded area) are shown. Black dots indicate the completion rate for each patient (n = 45) and each question asked but not necessarily answered.
FIGURE 5
FIGURE 5
Completion rate according to the question position in the weekly EMA. Relationship between the question ranking in the weekly EMAs and the completion rate. The predicted probability (blue curve) from the logistic mixed model and its 95% CI (shaded area) are shown. Black dots indicate the completion rate for each patient (n = 62) and each question asked but not necessarily answered.
See this image and copyright information in PMC

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